System and method for management of healthcare practice

ABSTRACT

A system to manage records in a healthcare practice includes a server and a memory that stores patient data records and inventory equipment records. A check-in client computing device and first and second HCP client computing devices run apps that program respective devices to check-in patients for appointments, retrieve, and store patient healthcare data at the server. Display screens show approved appointments and the apps sort appointments as selected. The patient check-in app verifies that patients meet check-in requirements and locks the appointments of patients who do not. Apps retrieve patient data for the approved appointments and sort them. The server stores examination, treatment, and prescription data. Equipment inventory delivery data and returns data are stored. The server is programmed to communicate with all apps in their form and format of data and to translate all disparate data types into that form and format.

CROSS REFERENCES TO RELATED APPLICATIONS

This application is a continuation of U.S. application Ser. No.16/579,719, filed Sep. 23, 2019, now U.S. Pat. No. 11,531,968, which isa continuation of U.S. application Ser. No. 13/843,031, filed Mar. 15,2013, now U.S. Pat. No. 10,424,033.

TECHNICAL FIELD

The disclosed technology relates generally to the healthcare industry,and more particularly, some embodiments relate to systems and methodsfor healthcare practice records management.

DESCRIPTION OF THE RELATED ART

While computers and computerized systems have found their way into mostof today's businesses, some sectors are more automated than others. Forexample, certain sectors of the healthcare industry have been slow toautomate their systems and procedures, or have yet to evolve into anintegrated, user-friendly computerized solution. This is true, forexample, with a number of small healthcare practices, family practices,and hospital systems in this country and around the world. However, thisshortcoming is not unique to small healthcare practices and indeed, manylarge healthcare practices suffer from a lack of proper automation andrecordkeeping. For example, some computerized systems in use todaygenerate multiple system-to-patient interactions, using different datamanagement systems each having different interfaces to the healthcareprovider and the patient. Electronic health records, schedulinginformation and billing information may be stored, tracked, andmaintained separately without an integrated approach to delivering thisinformation to the healthcare provider or their patients. This can leadto errors and efficiency with the data management systems.

BRIEF SUMMARY OF EMBODIMENTS

According to various embodiments of the disclosed technology, ahealthcare practice management system can be provided to assist managingthe data flow and operation of healthcare practices. In someembodiments, one or more applications running on client devices can beprovided to facilitate the sharing of information between data storagerepositories and the healthcare practice. For example, data stored inmultiple different data storage systems can be retrieved and provided tothe applications in a unified fashion. Likewise, data in differentformats, data stored with different encryption protocols and otherwisedisparate data types can be gathered, translated, and presented to theapplications in a form and format readable by the application.Encryption or other security measures can be employed to ensure dataprivacy is maintained to the appropriate standards.

The one or more applications can be configured to receive thisinformation and use it in the management of the healthcare practice. Forexample, patient-scheduling information, patient billing information,and patient electronic health records can be retrieved from therespective storage locations and deliver to the applications in a formand format that usable by the applications. This information can be usedto develop a patient schedule for the healthcare practice. The schedulecan be built as a daily, weekly, or biweekly schedule, or can be builtto a different timescale. The schedule can include an identification ofappointment times and patients corresponding to each appointment time.Where multiple physicians or other practitioners are involved in thehealthcare practice, the schedule can also indicate which physician orphysicians are scheduled to see which of patients. Likewise, otherresources needed for the schedule appointments can be identified foreach appointment. For example, wherein appointment requires laboratoryor other tests, those tests can be identified and associated with theappointment. Where special facilities, such as an operating room, forexample, are required, those facilities can also be flagged andassociated with a schedule appointment.

Accordingly, the one or more applications can be configured to presentthe scheduling information to the healthcare practitioners to facilitatemanagement and operation of the healthcare practice. Schedules can besorted by physician, treatment type, treatment facilities, or otherresources as may be appropriate. Healthcare practitioners may bepermitted to view the schedules and click on schedule entries toretrieve additional information about the scheduled appointment or thepatient. For example, clicking on a schedule entry can cause theapplication to retrieve information, such as, for example, patienthealthcare records of the patient scheduled for that appointment,billing information for that patient, resources scheduled to be used forthat appointment (e.g., a particular treatment rooms, test equipment,etc.) and the like.

The application can further allow the healthcare practitioners to enterinformation relevant to the scheduled appointment. For example, uponexamining a patient, the application can provide the ability for thehealthcare practitioner to enter information about the examination ortreatment provided. As a further example, the healthcare practitionermay enter data regarding a diagnosis made of the patient, actionsperformed during the patient's visit, prescribed medications for thepatient, recommended courses of action for the patient, follow-up testsor examinations, recommended treatments, and so on.

Where equipment is prescribed to the patient (e.g., a knee brace), theequipment prescription can be entered into the application and acceptedby the application. The application can be configured to provideprescription information to another healthcare practitioner who isdesignated to retrieve the prescribed equipment from inventory and fitthe prescribed equipment to the patient. Once equipment is fitted to thepatient, the healthcare practitioner can enter that information into theapplication, and the application can update the inventory records aswell as the patient's healthcare records. Likewise, billing informationcan be updated to reflect delivery of a billable item to the patient.

The healthcare practice management system can also be used to track,maintain and update other patient information such as, for example, thecheck-in and checkout of patients for appointments, insurance and co-payinformation, patient personal information, and other information usefulin the care and treatment of patients.

In some embodiments, a non-transitory computer readable medium includingexecutable instructions is provided, the executable instructions beingexecutable by a processor in a hand-held computing device to perform amethod, the method including: receiving a set of records, the recordsincluding patient identification for a plurality of patients scheduledfor to visit a healthcare practice; building a schedule, the scheduleshowing the patient identifications for the plurality of patientsscheduled and an appointment time corresponding to each patient;displaying the schedule on the hand-held computing device, wherein theschedule is sorted based on a sort order; accepting a first user inputfrom a health care practitioner, the first user input selecting apatient or a selected patient's corresponding appointment, and providingto the health care practitioner additional information corresponding tothe selected patient, wherein the additional information can include ahealth record of the selected patient; accepting a second user inputfrom a health care practitioner, the second user input enteringtreatment information, the treatment information including informationpertaining to an examination of the selected patient by the health carepractitioner; accepting a third user input from a health carepractitioner, the third user input entering prescription information forthe selected patient; updating the records for the selected patient, theupdates including the treatment information and the prescriptioninformation entered by a health care professional; accepting fourth userinput confirming fulfillment of the prescription; and sending theupdated records to update a central file repository. The recordsreceived can include records received from a data repository configuredto store records for a plurality of patients. The records can include atleast one of patient electronic health records, patient managementsystem records; and patient billing system records. The records furthercan include data relating to an outcome of prescribed follow-on care.

In some embodiments, the schedule can be sorted by a resource attributedto that schedule and displayed on the hand-held computing device can besorted by attending physician, appointment time, or treatment room.Displaying the schedule and accepting the first user input can includedisplaying appointment items in the schedule as linked elements on thedisplay, and wherein the linked elements are associated with a link tothe additional information corresponding to the patient. The informationcorresponding to the patient can include information included in therecords.

The information included in the records can include at least one ofpatient electronic health records, patient-management-system records;and patient billing system records. Further, the treatment informationcan include a patient diagnosis. In various embodiments, theprescription information entered by the healthcare professional caninclude a prescription for an orthopedic brace or other item stocked ininventory by the healthcare practice and the method can include updatingrecords of the inventory upon receipt of fourth user input confirmingfulfillment of the prescription.

In further embodiments, a non-transitory computer readable mediumincluding executable instructions is provided, the executableinstructions being executable by a processor in a client computingdevice to perform a method, the method including: receiving a set ofrecords, the set of records including patient identification for aplurality of patients scheduled for appointments at a healthcarefacility in a time window; displaying a schedule on a display of thehand-held computing device, the displayed schedule including a listingof entries for a subset of the appointments scheduled at the healthcarefacility in the time window; linking a schedule entry for a firstappointment to a subset of the set of records that corresponds to apatient associated with the first appointment; displaying the subset ofrecords to a healthcare practitioner in response to a request from thehealthcare practitioner for that subset of records; and accepting fromthe healthcare practitioner an order for a prescribed item for thepatient associated with the first appointment.

In some embodiments, the method can further include creating an orderrecord, the order record including information about the order for theprescribed item, wherein the order is displayed to a second healthcarepractitioner on a second client device, informing the second healthcarepractitioner to provide the prescribed item to the patient associatedwith the first appointment; and wherein the second client device createsor updates a record indicating that the prescribed item has beendelivered.

The method can also include accepting from the healthcare practitionerinput confirming delivery of the prescribed item to the patientassociated with the first appointment. In addition, the method caninclude updating inventory records to reflect that the prescribed itemhas been removed from inventory, and creating a patient billing recordto reflect that the prescribed item has been delivered to the patientassociated with the first appointment.

The method might also include accepting treatment information entered bythe healthcare practitioner, the treatment information includinginformation pertaining to an examination of the patient associated withthe first appointment by the healthcare practitioner.

In still further embodiments, a system in a medical office for managinga records associated with a plurality of patients, each patient beingscheduled for an appointment at the medical office is provided. In someembodiments, the system, may include: a first client computing devicehaving a first processor, a first user interface, and a firstnon-transitory computer readable medium including executableinstructions, the executable instructions being executable by the firstprocessor to perform a first method; a second client computing devicehaving a second processor, a second user interface, and a secondnon-transitory computer readable medium including executableinstructions, the executable instructions being executable by the secondprocessor to perform a second method. The first method can include:linking a schedule entry for a first appointment to a subset recordsthat corresponds to a patient associated with the first appointment;displaying the subset of records to a healthcare practitioner inresponse to a request from the healthcare practitioner for that subsetof records; and accepting from the healthcare practitioner an order fora prescribed item for the patient associated with the first appointment.The second method can include: accepting a third user input from ahealth care practitioner, the third user input entering prescriptioninformation for the selected patient; updating the records for theselected patient, the updates including the treatment information andthe prescription information entered by a health care professional;accepting fourth user input confirming fulfillment of the prescription;and sending the updated records to update a central file repository. Inaddition, the first method can include displaying a schedule includingthe schedule entry on a display of the hand-held computing device, thedisplayed schedule including a plurality of entries for a subset ofappointments scheduled at the healthcare facility.

Other features and aspects of the disclosed technology will becomeapparent from the following detailed description, taken in conjunctionwith the accompanying drawings, which illustrate, by way of example, thefeatures in accordance with embodiments of the disclosed technology. Thesummary is not intended to limit the scope of any inventions describedherein, which are defined solely by the claims attached hereto.

BRIEF DESCRIPTION OF THE DRAWINGS

The technology disclosed herein, in accordance with one or more variousembodiments, is described in detail with reference to the followingfigures. The drawings are provided for purposes of illustration only andmerely depict typical or example embodiments of the disclosedtechnology. These drawings are provided to facilitate the reader'sunderstanding of the disclosed technology and shall not be consideredlimiting of the breadth, scope, or applicability thereof. It should benoted that for clarity and ease of illustration these drawings are notnecessarily made to scale.

FIG. 1 is a diagram illustrating an example of a healthcare practicewith which the disclosed technology may be implemented in accordancewith one embodiment.

FIG. 2 is a high-level block diagram illustrating one example ofinformation sharing in accordance with one embodiment of the technologydescribed herein.

FIG. 3 is a diagram illustrating an example process that can beimplemented by an application in accordance with one embodiment of thetechnology described herein.

FIG. 4 is an operational flow diagram illustrating an example processfor scheduling in accordance with one embodiment of the technologydescribed herein.

FIG. 5 is an operational flow diagram illustrating an example processperformed by an application to facilitate patient check-in to thehealthcare facility.

FIG. 6 is an operational flow diagram illustrating an example processfor providing data to and accepting data from one or more healthcarepractitioners who may be examining or treating the patient.

FIG. 7 is an operational flow diagram illustrating an example processfor managing the delivery of a prescribed item in accordance with oneembodiment of the technology described herein.

FIG. 8 is an operational flow diagram illustrating an example processfor patient check out in accordance with one embodiment of thetechnology described herein.

FIG. 9 is a block diagram illustrating an example data management systemin accordance with one embodiment of the technology described herein

FIG. 10 is an operational flow diagram illustrating an example processfor transferring information used by a healthcare management system inaccordance with one embodiment of the technology described herein.

FIG. 11 illustrates an example computing module that may be used inimplementing various features of embodiments of the disclosedtechnology.

The figures are not intended to be exhaustive or to limit the inventionto the precise form disclosed. It should be understood that theinvention can be practiced with modification and alteration, and thatthe disclosed technology be limited only by the claims and theequivalents thereof.

DETAILED DESCRIPTION OF THE EMBODIMENTS

The technology disclosed herein is directed toward systems and methodsfor healthcare practice management, data integration and automation.According to various embodiments, various aspects of a healthcarepractice can be automated, and data shared amongst the severalcomponents and systems within and external to the healthcare practice.For example, patient and resource scheduling, records updating, billingand reporting can be automated.

Before describing the technology in detail, it is useful to describe anexample environment in which the technology can be implemented. One suchexample is that of a medical or healthcare practice. FIG. 1 is a diagramillustrating an example of a healthcare practice with which thedisclosed technology may be implemented. In general, the healthcarepractice can include one or more medical practices such as, for example,an orthopedic medicine practice, a sports medicine practice, a pediatricpractice, a general practitioner/family practice, and so on. The one ormore medical practices can include physicians, physician assistants,nurse practitioners, radiologists, physical therapists and otherhealthcare professionals. The one or more medical practices can belocated in a single facility or distributed across a plurality offacilities. With reference to FIG. 1 , an exemplary healthcare practicecan include one or more of a server 31, server data storage 32, a frontdesk 33, and a billing department 34, inventory 35, treatment rooms 36,test facilities 37, scheduling and prescriptions 38, one or morehealthcare providers 39, one or more surgical theaters were operatingrooms 40, cloud data storage 41, and other internal resources 44 andexternal resources 45.

Server 31 and its associated data storage 32 can be centralized ordistributed, and can be configured to store any of a number of differenttypes of data for the healthcare practice. This can include, forexample, data such as patient records, including electronic healthrecords (EHR); scheduling information; billing information; and otherinformation and records used in the management, operation andmaintenance of the healthcare practice. In addition to data storage 32,each of the other resource units in the healthcare practice can includeits own computing and data storage capabilities. In addition to or inplace of data storage 32 (and other data storage capabilities) cloudstorage 41 can be provided to store data and information used in thehealthcare practice. Cloud storage 41 can be configured to be accessibleby server 31 as well as by other computing capabilities of thehealthcare practice. Although one server 31 is illustrated, as would beapparent to one of ordinary skill in the art after reading thisdescription, a number of different servers 31 can be provided in variouslogical and physical groupings.

Front desk 33 can be provided to greet and check-in patients at thehealthcare facility. Depending on the size of the healthcare facility,front desk 33 may also be responsible for the functions of billing 34and scheduling 38 as well as inventory 35. Billing 34 receivesinformation regarding a patient visit, receives insurance and paymentinformation from the patient, generates billing statements, recordspayments and tracks Accounts Receivable. The information regarding thepatient visit used by billing 34 can include information such as, forexample, the doctor or healthcare provider visited by the patient,supplies provided to or used in the treatment of the patient, articlesdelivered to the patient (e.g., a knee brace, crutches, etc.) and otherinformation used to generate the bill. Inventory 35 can include suppliesand other inventory used in the operation of the healthcare practiceincluding inventory used in the treatment of patients. For example, inthe case of an orthopedic practice, the inventory may include variouselbow, knee, and other braces that may be provided or prescribed to apatient. The inventory may also include all other inventory (includingconsumables) used by the healthcare practice. Inventory levels can betracked and managed electronically and the reordering of supplies can beautomated. Scheduling and prescriptions 38 can be included to provideassistance with scheduling patient visits such as, for example,follow-on appointments, tests, and other events. Scheduling andprescriptions 38 can also manage patient prescriptions, which caninclude interfacing with pharmacies or other like fulfillment providers.

The healthcare practice generally includes one or more healthcareproviders 39 to provide treatment and other services to the patients.Healthcare providers can include, for example, physicians, physicianassistants, nurses, nurse practitioners, physical therapists, labtechnicians and the like. The healthcare practice can also include oneor more treatment rooms 36, test facilities 37 and surgical theaters 40.Treatment rooms can include, for example, locations in which a physicianconsults with her patient, were treatment is given to the patient. Testfacilities 37 can include facilities such as x-ray facilities, MRIfacilities, treadmills, ultrasound equipment, and laboratories, just toname a few.

As would be apparent to one of ordinary skill in the art after readingthis description, various different healthcare practices may use otherinternal or external resources 44, 45 in the course of their practice.These and the other described resources can be communicatively coupledto one another, for example, using networking technology. Accordingly,electronic records and other data can be shared among the variousresources to facilitate performance of a given resource's determinedfunctions. Also, as noted above, the resources can include computingcapabilities used in performance of their tasks.

As described in more detail below, client computing devices withapplications running thereon can be provided for use by personnel of thevarious resources to manage their tasks and responsibilities. Theseclient computing devices can be handheld computing devices (e.g., tabletcomputers, iPads, smart phones, laptops, etc.) and can becommunicatively linked to the healthcare provider network such thatinformation (e.g. patient information, treatment information,prescription information, billing information, and so on) can be sharedbetween the client devices and the various resources of the healthcarepractice. In example embodiments discussed below, these client devicesare described as handheld computing devices. However, after reading thisdescription, one of ordinary skill in the art will understand how toimplement the features and functionality described herein using desktop,wall-mounted, equipment-integrated, or other computing devices toperform the client computing functions.

A workflow management service 48 can be included with the healthcarepractice to manage the data and information in the healthcare practiceand to provide information to the client computing devices. In variousembodiments, workflow management service 48 can be integrated withserver 31 (e.g., an application running on server 31), it can beintegrated with other computing resources in the healthcare facility, orit can be a stand-alone service with dedicated computing resources.workflow management service 48 can be configured to consolidate data andinformation from data storage facilities within healthcare facility(e.g., cloud storage 41, data storage 32, and data stored at variousresources) as well as information received from sources external to thehealthcare facility.

Workflow management service 48 can be configured to gather thisinformation and provide it to the one or more client computing devicesused in the healthcare facility. For example, in some embodiments,workflow management service 48 retrieves a predefined set of information(e.g. patient electronic health records, billing records, schedulingrecords, etc.) and provides this information to the client computingdevices. The information can be tailored for one or more clientcomputing devices or groups of client computing devices or all of thegathered information can be sent to the client computing devices. Forexample, particular pieces of information relevant to a resource withwhich a client computing device is associated can be culled from thefull set of gathered information and send to that associated clientcomputing device. As a further example, patient health records andscheduling information may be gathered and sent to one or more clientcomputing devices used by physicians or other healthcare providers 39 inthe healthcare facility. Still further, in facilities where there aremultiple healthcare workers (for example, physicians), patient recordscan be gathered and sorted such that each physician receives only thatinformation pertaining to his or her patients.

As another example, billing and scheduling information might be gatheredand sent to the billing department 34. Accordingly, client computingdevices (or applications running thereon) can be identified withspecific personnel at the healthcare facility or with particularresources or functions of the healthcare facility. In this manner,tailored sets of information can be delivered to specific clientcomputing devices to avoid the need to download all data to all devices.In some embodiments, the client computing devices are identified byinformation coded into the applications. In other embodiments, theclient computing devices can be identified based on login informationprovided by healthcare worker. In this latter example, client computingdevices can be shared amongst different practitioners, such, as forexample, across different shifts.

As stated above, in the example healthcare practice, the variousresources can each include computing capabilities and various clientcomputing devices can be provided for use as well. In order for thesedevices to operate well and for the functions of the healthcare practiceto be integrated, these devices can be configured to share informationwith one another as may be relevant to their respective resourcefunctions. FIG. 2 is a high-level block diagram illustrating one exampleof information sharing in accordance with one embodiment of thetechnology described herein. Referring now to FIG. 2 , this exampleincludes a central data repository 71, the data interface 72, and one ormore applications 73.

Central data repository 71 can be configured to store records andinformation germane to the healthcare practice. For example, centraldata repository 71 can be configured to store electronic health records(EHR), patient billing records and other billing information, patientscheduling information, resource scheduling information, inventoryinformation, and other information relevant to the healthcare practice.Central data repository can be a centralized data store or it canencompass data storage facilities distributed within and external to thehealthcare practice. For example, central data repository 71 canencompass cloud storage 41, server data storage 32, and other datastorage elements. By way of example, consider a hospital environment inwhich a plurality of different healthcare practices may be registered toadmit and treat patients in the hospital. In such an environment,central data repository 71 can comprise data storage for the hospitaldata records, and applications 73 from a plurality of differentregistered healthcare practices can be given access to the informationin central data repository 71.

Application 73 can include healthcare practice management applicationsrunning on one or more client devices used in the healthcare practice.Application 73 can include the functionality to retrieve or pullinformation from data repository 71 including, for example, patienthealth records (e.g., EHR), scheduling information and billinginformation. Application 73 can be a single application or it caninclude multiple applications running on a device. As described infurther detail below, application 73 can be configured to performfunctions such as build a schedule for the healthcare practitionerassigned to or logged into a particular client computing device; providepatient health records and other patient information to the healthcarepractitioner treating a patient; receive diagnosis and treatmentinformation for a patient entered by a healthcare practitioner; receiveprescription information for a patient from an attending physician orother healthcare practitioner; receive confirmation of delivery ofprescribed materials; update inventory records based on materialsprescribed and supplies used in treating a patient; update patientbilling records based on information such as treatment provided,facilities and supplies utilized, materials prescribed, and the like;and receive scheduling information for future patient treatments orfollow-ups.

In some embodiments, application 73 can be one or more applicationsconfigured to run on their respective client computing devices. Forexample, different client devices for different facility resources mayrun different applications 73. For example, a physician's application 73may be provided for use by a physician on his or her client computingdevice. Likewise, applications 73 tailored to a physician assistant, anurse or nurse practitioner, a laboratory or test clinician, and otherfacility resources can be provided. In another embodiment, application73 can be a common application used by client computing devices at allof, or a subset of facility resources. Therefore, although the examplesdescribed herein in some instances refer to a specific application 73(e.g., a physician's application or a nurse's application) one ofordinary skill in the art after reading this description will understandthat a common application can be provided to perform functions of thespecific applications. In still other embodiments, the functions ofapplication 73 can be shared among a given client computing device andanother computing resource such as, for example, workflow management 48.

Data interface 72 can be included to provide a communications interfacebetween central data repository 71 and the one or more applications 73used in the healthcare practice. For example, data interface 72 can beprovided to retrieve the necessary particular information from centraldata repository 71, and provide it to one or more designatedapplications 73. In some embodiments, data interface 72 can beconfigured to pull the information from central data repository 71 andbroadcast it to all client devices or applications 73, or it canselectively send certain pieces of information or certain informationtypes to specific client devices or groups of client devices. Forexample, data interface 72 can be configured to send billing records andbilling information to all applications 73 or client devices, or only tothose application 73 or client devices used by the billing department orthat may be otherwise used by personnel who would benefit by having thatinformation.

With HIPPA in particular and other privacy concerns in general,information storage in the various data storage locations associatedwith and external to the healthcare practice may be encrypted orotherwise protected. Additionally, because there can be a variety ofdifferent data types accessed by the system and the data can be storedat different data storage locations, the data retrieved by datainterface 72 may be in different formats. Accordingly, in someembodiments, data interface 72 can be provided with functionality todecrypt data that has been encrypted with a variety of differentencryption types and encryption keys, and to re-secure the data (e.g.re-encrypt the data) prior to delivering it to applications 73.Additionally, data interface 72 can be provided with functionality toaccess and read data in a variety of different data formats and datatypes, and translate that format into one that is legible to theapplications 73.

In addition to retrieving data and providing to application 73, datainterface 72 can also be configured to receive data from application 73and push or send that data to central data repository 71. This data pushcan be used to update healthcare records and other information at thecentral data repository 71 with information entered by healthcarepractitioners or otherwise received from the healthcare facility inconjunction with the treatment or follow-up of the patients. Forexample, billing record updates, electronic health record updates,scheduling updates, prescription record updates, inventory updates, andother like information can be pushed by the applications 73 to datainterface 72 (or pulled by data interface 72 from the applications 73)and provided to central data repository 71.

As with retrieval of data from central repository 71, data interface 72can likewise ensure that the data is secure for transmission fromapplication 73 to central repository 71, as well as perform any formatchanges necessary to provide the data in the proper format expected bythe various components of central repository 71. For example, data sentencrypted using one encryption format by an application 73 can bedecrypted by data interface 72 and re-encrypted into an encryptionformat anticipated by central data repository 71. Because central datadepository 71 can include data stored by a number of different systems,data interface 72 can be configured to decrypt information received fromone source, and re-encrypt the information for transmission to variouscomponents or systems using their respective encryption techniques.

FIG. 3 is a diagram illustrating an example process that can beimplemented by an application 73 in accordance with one embodiment ofthe technology described herein. FIG. 3 provides a high-level discussionof some of the features and functionality that can be provided by one ormore application 73. Various aspects of these features andfunctionalities are described in greater detail following the discussionof FIG. 3 . Referring now to FIG. 3 , at a step 111 application 73receives patient information from data storage. For example, in terms ofthe embodiments described above, application 73 can receive patientinformation from central data storage 71 either directly or indirectly.For example, application 73 can receive data via an interface such asdata interface 72. The patient information received can include healthrecords, scheduling information, billing information and otherpatient-related information.

As stated above, the information received by a particular application 73can be specific information tailored for that application. For example,a physician may log onto a client device with his or her specific ID andpassword. Alternatively, the application 73 may be running on a clientdevice assigned to that particular physician. Accordingly, based onidentification of the particular physician, specific patient informationcan be retrieved and downloaded to that application 73. In this manner,only records for patients that are identified as being seen by thatphysician are retrieved. In other embodiments, information for allpatients can be received and the application 73 can be configured tosort and filter the information for a particular physician. For example,in one embodiment, a group of applications 73 running on differentclient devices may all receive information for all the patients beingtreated by that healthcare facility on that particular day.

At operation 113, application 73 builds a schedule of patients oractivities for a particular time period (e.g., for a shift or for theday). For example, a schedule of patients and appointment times can begenerated for one or more healthcare practitioners in the healthcarefacility. Likewise, a schedule of patients and appointment times can begenerated for facility resources such as test facilities (e.g., stresstest facilities), diagnostic facilities (e.g., ultrasound equipment),treatment rooms, operating rooms, and other facility resources.Accordingly, for example, application 73 can be configured to provide aparticular healthcare worker with a schedule of patients to be seen bythat worker, a list of tests or treatments to be performed, andresources scheduled for those patients. As a further example application73 can be configured to provide an ultrasound operator with a scheduleof patients to be seen by the operator, a type of ultrasound procedureto be performed for each patient, and particular ultrasound equipment(if any) to be used for the procedure for each patient.

Application 73 can be configured to sort the schedule based on attendingphysician, designated treatment room, and the like. Accordingly, whenthe healthcare provider accesses the application 73, the healthcareprovider can access the schedule of patients assigned to his or herrounds for that day. Because the application 73 received information forall patients (or a group of patients) the healthcare provider can alsohave access to schedules and other information for patients being seenby other practitioners.

At operation 115, application 73 displays schedule information to thehealthcare worker. For example, application 73 can be configured topresent a list of scheduled appointment times and patient names to thehealthcare worker. As noted above, the information can be filtered forthe particular healthcare worker or resource associated with theapplication 73. Alternatively, the information can include scheduledappointment times and patient names for other patients as well. In suchembodiments, application 73 can be configured to sort the informationbased on a plurality of different sort criteria.

The schedule includes buttons, links or other UI keys allowing thehealthcare worker to select a particular patient or appointment andretrieve additional information about that patient or appointment.Selection of a particular patient or appointment can allow thehealthcare worker to access information such as patient health records,billing information, purpose of visit, and so on. Accordingly, thehealthcare worker can access information about the patient in order toprovide the intended treatment. Upon providing the treatment, theapplication allows the healthcare worker to enter information about thetreatment. This is illustrated by operation 117 in which the applicationreceives a diagnosis and treatment information entered by the healthcareworker.

In some cases, the diagnosis or treatment of the patient will lead to aprescription for that patient. The prescription can be for medications,or for devices (e.g., crutches, knee or elbow brace, eyeglasses, etc.).Likewise, the physician may prescribe follow-on treatments, exerciseregimens, dietary restrictions, or other procedures or activities. Ondetermining whether one or more prescriptions are appropriate for thepatient, the healthcare provider can enter the prescription informationinto the client computing device. For example, in one embodiment, uponthe entry of diagnosis and treatment information, application 73 canprompt the healthcare provider to enter prescription information. Atoperation 119, application 73 receives the prescription information andstores it as part of patient's updated health records. The prescriptioninformation can be shared with other resources at the healthcarefacility for fulfillment of the prescription. Accordingly, at operation121 the prescription information is provided to the appropriateresources at the healthcare facility. For example, in the case of aprescription for medicaments, the prescription record can be provided tothe front desk and a written prescription given to the patient uponcheckout. Likewise, the prescription can be electronically transmittedto a pharmacy and the patient provided with a confirmation on checkoutregarding the prescription and the pharmacy. As yet another example, theprescription can be electronically transmitted to an on-site pharmacy anon-site pharmacy such that it can be fulfilled and the prescription canbe picked up by the patient before departing the facility, or can bepicked up by a healthcare worker and delivered to the patient.

As another example, consider a case in which the prescription is for anorthopedic apparatus such as an elbow or knee brace. This usuallyinvolves fitting the apparatus to the patient. In this example, theprescription can be delivered to a nurse practitioner or physicianassistant who is designated to fit the device to the patient. In variousembodiments, the nurse practitioner or physician assistant also uses aclient computing device to receive the prescription information and tofulfill the prescription. Particularly, the healthcare worker isnotified via application 73 on his or her client computing device thatan orthopedic apparatus has been prescribed for patient and that thepatient is ready for fitting. In other embodiments, paper or otherrecords can be used to notify the health care worker that the orthopedicapparatus has been prescribed for patient. The information provided tothe physician assistant can include an identification of the orthopedicapparatus to be provided and any fitting instructions necessary.Accordingly, the physician assistant retrieves the prescribed orthopedicapparatus from inventory and fits the apparatus onto the patient. Oncethe orthopedic apparatus is fitted, the physician assistant can updatethe client computing device with confirmation of the fitment.Accordingly, at operation 123, application 73 receives confirmation ofdelivery of the prescribed orthopedic apparatus.

When the treatment is completed, the healthcare worker can indicate suchcompletion in a window of application 73, and application 73 can beginchecking out the patient. This is illustrated by operation 125. As partof the checkout process, patient records can be updated and instructionscan be given to workers at the healthcare facility to facilitate thecheckout process. For example, diagnosis information, prescriptioninformation, test results, follow-up instructions, and other informationrelating to the patient's visit is gathered by application 73 during thepatient's visit. This information can be uploaded to central datarepository 71 (e.g., via data interface 72) to update patient records.

Uploads to a central data repository 71 for this and other data typescan be performed in real-time or near-real-time during the patientvisit, upon completion of the patient visit, or in a batch mode atpredetermined time intervals (e.g., at the close of business). Billinginformation can be compiled for the patient visit, tests performed,supplies provided, prescription items delivered in other billinginformation. Likewise, payment information can be compiled for thepatient including payments or copayments made by the patient, insuranceinformation, and receives insurance endorsements. This information canalso be provided to central data repository 71. Additionally, wherefollow-up visits or future tests are scheduled, the schedulinginformation can be accepted by application 73 and also uploaded tocentral data repository 71.

FIG. 4 is an operational flow diagram illustrating an example processfor scheduling in accordance with one embodiment of the technologydescribed herein. Referring now to FIG. 4 , at operation 153,application 73 receives schedule data. For example, application 73 canbe configured to pull information from central data repository 71.Information pulled can include information such as patient informationand schedule information. Additionally, at this step application 73 canpull all information for patient visits (even if it is not used forscheduling) during the pull operation.

At operation 155, application 73 builds a schedule. The schedule can bea master schedule for the healthcare facility, individual schedules forhealthcare facility resources (e.g. physicians, test equipment,treatment rooms, etc.) or both. Accordingly, the schedule can be builtby an individual application 73 running on a particular client computingdevice, or it can be built by a centralized application (e.g., anapplication 73 running as part of workflow management 48). In someembodiments, the schedule can be a scheduled listing of patients to beseen at the healthcare facility and the schedule times of theirappointments. The schedule can be generated so as to display on theclient computing devices for review or approval by healthcarepractitioners.

At operation 161 the schedule can be filtered or sorted, or both, for aparticular application 73 or group of applications 73. For example,where multiple physicians hold hours in the healthcare facility, theschedule can be filtered or sorted by physician (or by other caregiver).Therefore, a physician only needs to view his or her schedule patientswhen planning the day or conducting rounds. As another example, theschedule can be sorted or filtered based on test facilities orequipment, treatment rooms, operating rooms, or other resourcedesignation. This can allow a caregiver responsible for operating aparticular facility or resource to view a schedule tailored to theresources for which he or she is responsible. In some embodiments, anapplication might only request the information that is relevant to theresource with which it is associated, thereby building a tailoredschedule for that application. In other embodiments, a masterapplication (whether on a client device, part of workflow management 48,or otherwise) can build one or more schedules for a plurality ofapplications 73 and deliver those schedules (filtered, sorted, orotherwise) to the appropriate applications 73. In yet anotherembodiment, the schedule or schedules can be built by computingresources at central data repository 71 and distributed to the clientresources.

At operation 163, patient records are made available by the clientapplications 73 to the healthcare provider. The patient records caninclude information such as, for example, electronic health records(EHR) 156 of the patient, scheduling information 157 of the patient andpatient billing records 158. The patient records may also includeoutcome-related data and information, including information relating torecovery of the patient. For example, this can include the patient'spost-surgery recovery status, response to physical therapy or otherfollow-on treatments, success of a fitted brace, and so on. Theelectronic health records 156 can include information from past visitsby the patient as well as electronic health records for that patienttransferred to the healthcare facility by a previous caregiver.Accordingly, by opening a schedule entry, that that patient's healthcarerecords can be reviewed by the healthcare provider before, during andafter the patient visit. Electronic health records may for example,contain information pertaining to a patient's condition, results ofprior tests, prior diagnoses, x-rays, prior prescriptions, prescribedmedications, follow-up information, and other information normally foundin a patient's health records. Electronic health records can be updatedby the caregiver during treatment.

Schedule information 157 can include information regarding a scheduledtime and place for the current appointment and any other schedulinginformation that may be relevant. Billing information 158 can includeinformation about a patient's account history including, for example,insurance information, prior payment information, account balances, andso on. Insurance information may be useful, for example, to inform thecaregiver as to what treatment options may be available depending on apatient's coverage. While billing information might not be important toa physician for purposes of the office visit, this information can beaccessed by other resources including the front desk, which may need tocollect co-pays or additional insurance information, or the billingdepartment, which may need to update its records and send out billing orreminder statements.

Accordingly, clicking on or otherwise opening a schedule entry canprovide the healthcare practitioner with access to patient information156, 157, 158 about the patient corresponding to that entry and his orher treatment.

FIG. 5 is an operational flow diagram illustrating an example processperformed by an application to facilitate patient check-in to thehealthcare facility. At operation 185 a patient arrives at and checks into the healthcare facility. For example, the patient may sign in at afront desk and provide the front desk attendant with his or her name oridentification. As another example, a kiosk may be provided to allowself check-in. Application 73 provides the schedule to the front deskattendant at operation 186. For example, the schedule can be displayedon a display screen of a client computing device for the front desk. Theattendant can consult the schedule to locate the patient checking in.

The reception-desk attendant can open the appropriate schedule entry toview additional patient information that may be pertinent to thecheck-in process. At operation 189 this information is presented to theattendant. This information can include, for example, information suchas a paperwork that will need to be prepared by the patient prior to theappointment, insurance information that may be required from thepatient, and other information. If additional information is requiredfrom the patient, this information can be requested of an obtained fromthe patient. The attendant can enter the updated information into theapplication. For example, the attendant can enter new or updatedinsurance information, and indication that appropriate copayments weremade, and so on. This information is received by the application toupdate patient records. This is indicated by operation 191.

When the information is completed, at operation 193 the scheduledappointment is approved so the patient can be seen. In some embodiments,requiring approval of the appointment at one or more steps along theappointment process can serve as a gatekeeping function to managepatient flow. For example, the schedule may be locked or flagged forcertain resource applications until approval at or prior gatekeepingstep is given. As a further example, the schedule appearing on aphysician's application may be marked with a flag, highlighted, orotherwise noted as being locked until approval by the front desk isprovided. As yet a further example, the schedule appearing on a testoperator's application may be locked until the physician has seen thepatient and approved the patient's condition for the test.

Operation 195 any updated or additional information obtained from thepatient during the check-in process can be stored locally by the clientcomputing device, and uploaded to central data repository 71 to updatethe main record database. This upload to central data repository 71 canbe done in real time or near real-time, or can be done in a batch modeat periodic (e.g. daily) intervals.

As described above, in various embodiments one or more application 73can be used to provide patient data to and accept patient data from oneor more healthcare practitioners. FIG. 6 is an operational flow diagramillustrating an example process for providing data to and accepting datafrom one or more healthcare practitioners who may be examining ortreating the patient. For clarity and ease of discussion, FIG. 6 isdescribed in terms of the specific example. The specific example is thatof the patient who is first seen by a nurse and then by a physician. Inthis example, the nurse performs preliminary blood pressure, heart rate,temperature, and weight measurements on the patient. Subsequent to thesemeasurements, the physician examines the patient. While the exampleshown in FIG. 6 is an example use of the application by a nurse and aphysician during a patient visit, one of ordinary skill in the art afterreading this description will appreciate how the application can beconfigured to operate with other healthcare resources or practitioners.

Referring now to FIG. 6 , at operation to 225 the application isconfigured to receive patient information from the nurse. For example,in operation when a nurse calls a patient into for examination, thenurse can open the patient schedule using the application on his or herclient computing device and enter a data entry mode. The nurse can thenmake the desired patient measurements (e.g., weight, blood pressure,pulse, etc.) and enter the results into the client computing device.These results are received by the application and the applicationupdates the patient's health records accordingly. This is illustrated byoperation 228. In the above-described example, manual entry of theresults are accepted by the client computing device. In otherembodiments, wireless, hardwired or other electronic communication canbe provided between the measurement equipment (e.g., scale,sphygmomanometer, etc.) and the data transferred electronically.

At operation 231, the physician application retrieves electronic healthrecords. In some embodiments, this information can be downloaded whenthe schedules are created and stored locally to the client computingdevice for access by the application when needed. In other embodiments,information can be downloaded when the patient is check-in or at thestart of the patient's appointment.

At operation 233, the patient's health records are made available to thephysician. For example, in one embodiment, a button or other icon can beprovided on the user interface such static physician can click to accessthe health records. Upon accessing health records, it can be displayedby the application to the physician on the user interface of the clientcomputing device. This is done so that the physician attending to thepatient can review the patient's records prior to and during thetreatment. Where multiple pages of health records are involved, the userinterface can allow a position to scroll through health records andpatient history to obtain information needed. Additionally, searchfunctions can be provided to locate specific items of information withinthe health records. Although not illustrated in FIG. 6 , the nurse'sapplication can also retrieve and display electronic health records ofthe patient.

At operation 236, the physician's application accepts treatmentinformation from the physician. This treatment information can includeinformation such as, for example, the diagnosis and information aboutthe diagnosis, information obtained by the physician during treatment,physician observations, and other information the physician may deemuseful, important or required for the health records. Particularly, thephysician examines the patient and gathers information about thepatient's condition. The physician may make a diagnosis regarding thepatient's condition as well. The physician's application provides awindow or data entry screen into which the physician can enter thisdata. Accordingly, the application can update the patient's healthrecords with the current diagnosis, treatment information,recommendations by the physician, and other information entered by theposition. The data entry can be made using a keyboard (touchscreen orotherwise), speech recognition software, or other data entry techniques.

During the course of the patient visit, the physician may also prescribeor recommend medication, treatment devices (e.g., an orthopedicapparatus, crutches, etc.), tests, and so on. Accordingly, at operation238 the physician's application user interface provides a window orscreen into which this information can be entered. Upon entry, theapplication receives the entered information, creates an order recordfor the prescribed item(s), and updates the health records of thepatient. The order record can include, for example, identification ofthe prescribed item, prescription instructions, and other prescriptioninformation. The identification of the prescribed item can include, forexample, a medication and unit dosage; an identification of a specificapparatus like a particular knee or elbow brace; identification offollow-up tests or procedures and so on. The prescription instructionscan include, for example, patient dosages for medication and otherinformation relevant to the prescribed item.

In some embodiments, the physician may be required to enter a PIN orother authorization code before the prescription is accepted by thesystem. This can add a measure of security to the system, allowing onlyauthorized personnel to enter prescriptions or certain orders. This canalso be used to track inventory to a particular practice or physician.In some embodiments, the physician's original login is sufficientauthorization for entry of the prescription. In other embodiments, aseparate PIN or authorization code is required. Additionally, in someembodiments, the prescription information is provided to otherhealthcare facility resources for follow-on action. This is illustratedby operation 241. In various embodiments, particular resources can beidentified to receive prescription information for particularprescriptions or orders. For example, the prescription may be sent to aparticular resource based on the prescription type. That is,prescriptions for medications can be sent to the front desk for printingor to an in-house pharmacy; while prescriptions for orthopedic devicesmay be sent to a physician assistant who can retrieve the prescribedapparatus from storage and properly fit the apparatus to the patient. Anexample of this is described in greater detail below.

In addition to prescriptions described above, the physician may provideinstructions or other information to the patient regarding futurecourses of action. For example, the physician may recommend a particulardiet or exercise routine to the patient. Additionally, the physician mayrecommend or follow-up tests or procedures for the patient. Accordingly,at operation 243, the physician's application is configured to acceptthese recommended patient actions or instructions. For example, thephysician's application may provide a data entry window or screenallowing the physician to enter this information.

At operation 246, the information entered at operations 236, 238, and241 can be used to update the patient health records at central datarepository 241. As with other data updates the can be provided using thetechnology disclosed herein, this data update can be made in real-timeor near-real-time as the data is entered, or it can be uploaded tocentral data storage 71 at a predetermined time or at predetermined timeintervals (e.g. at the end of a shift, at the close of business, orother designated time).

FIG. 7 is an operational flow diagram illustrating an example processfor managing the delivery of a prescribed item in accordance with oneembodiment of the technology described herein. As discussed above, invarious embodiments, the application 73 (e.g. a physician's application)can accept and receive prescription information for a patient. Thisprescription can be entered by the physician or other prescribingclinician at the appropriate user interface of the application 73. Forclarity and ease of description, the process of FIG. 7 is described interms of a specific example in which a patient is prescribed aparticular knee brace. After reading this description, it will becomeapparent to one of ordinary skill in the art how this process can beapplied for other prescriptions or orders.

Referring now to FIG. 7 , at operation 251, prescription or order isprovided to the physician assistant who is going to fit the knee braceon to the patient. Particularly, in some embodiments, the physician'sapplication can be configured to send the prescription to the physicianassistant's application. Accordingly, the physician assistant can viewthe prescription on his or her client computing device, determine theprescribed knee brace, and retrieve it from inventory. A key code can beprovided with the prescription to allow the physician assistant accessto the inventory.

At operation 253, the prescribed item scanned by the physicianassistant's application. For example, the application can includerecognition software configured to recognize a barcode, stock number,RFID tag, NFC tag, or other like identification of an item retrieved bythe physician assistant from inventory. The identification of the itemretrieved compared to the item identified in the prescriptioninformation to determine whether the correct item has been pulled frominventory. Accordingly at operation 255, the physician assistant'sapplication confirms that the scanned item matches the prescription.Once confirmed, the inventory records can be updated to reflect the factthat the item has been removed from inventory. This is shown atoperation 258.

With the prescribed item in hand, the physician assistant can return tothe treatment room to fit the knee brace to the patient. The physicianassistant can instruct the patient on proper fitting, application andadjustment of the knee brace, as well as provide patient any otherinformation here she may need regarding the product. The applicationallows the physician assistant to confirm that the prescribed item wasin fact delivered to the patient. Accordingly, at operation 260, thephysician assistant's application receives confirmation of the delivery.As is the case with the physician's application described above, thephysician assistant's application can be configured to accept diagnosis,treatment, and other information from the physician assistant, and itcan allow the physician assistant to identify or recommend exercises,follow-up tests, or other follow-on opportunities for the patient. Atoperation 263, information provided by the physician assistant can beused to update the patient's billing and health records.

If the item prescribed to the patient does not fit properly or isotherwise not delivered to the patient, the item may be returned toinventory or discarded. In the event an item is returned to inventory,the physician assistant can note the return through his or herapplication, and the application can update the inventory recordsaccordingly.

With the patient having been examined by a physician and having receivedany prescribed deliverable items, the patient may now begin the checkoutprocess from the facility. An example process for checking out thepatient is illustrated in FIG. 8 in accordance with one embodiment ofthe technology described herein. The checkout process can entailscheduling a next appointment, and scheduling tests or other follow-upactions. Accordingly, at operations 315 and 317, the front deskapplication can allow the attendant to schedule the next appoint and anyfollow up tests or actions.

At operation 319, the attendant can deliver prescriptions to thepatient. For example, where the practitioner prescribed medication forthe patient and prescription for that medication into the application,that prescription can be delivered to the front desk application. Theattendant can retrieve the prescription and print it out for thepatient. Additionally, instructions and other materials identified bythe healthcare practitioner can be printed and delivered to the patientat this time. Alternatively, diet routines, exercise regimens and othermaterials can be provided to fax, e-mail or otherwise transmit theprescription to a patient's desired pharmacy. In some embodiments videosor other multimedia content can be stored on the system and prescribedto the patient. For example, follow-on care instructions, specificexercise routines, safety information and other information andmaterials may be stored on the system and prescribed to the patient forviewing. Accordingly, the system can be configured to email or otherwisedeliver the content, or links to the content, to the patient for access.Authentication or login codes may also be provided to the patient forsuch access.

At operation 321, the attendant can update the patient's informationwith any additional information and confirm completion of theappointment. This information can be received by the attendant'sapplication and made available for printout. Alternatively, it can bee-mailed to the patient had a designated e-mail address.

At operation 323, the billing information can be collected in theappropriate bill assembled for the patient. This can be done by abilling application within a billing department 34 or at front desk 33(or other location as determined for a particular facility). Billingrecords can be updated to include the visit and any pertinent detailsregarding the visit, materials and supplies used for the visit orprovided to the patient, tests or other operations performed, and so on.

As the above examples illustrate, various embodiments of the application73 provide the opportunity for a physician, practitioner, clinician, orother healthcare worker to enter information pertaining to a patientvisit into the client computing device. In various embodiments,depending on the type of information, application 73 may prompt the userto enter particular types of information. In other embodiments,healthcare worker may be required to initiate the data entry process.Various forms of data entry can be provided including, for example,keyboard entry, touchscreen entry, voice-recognition, menu selections,and the like.

For example, a menu of selections can be provided to allow the user toselect particular data entry items. As a further example, where thephysician intends to prescribe a knee brace, the application provide onthe UI a menu of available knee braces, allowing the physician to selectfrom among the list of possibilities. As yet another example, thephysician may call up a list of different diet regimens and select oneor more diet regimens for among those listed to be prescribed to anddelivered to the patient. These can be provided as pre-writteninstructions or pre-prepared diets to be selected for entry into thepatient's health records and for delivery to the patient. Similarly, alisting of tests or other follow-on procedures can be provided fromwhich the physician can choose.

As stated above with reference to FIG. 2 , in various embodiments a datainterface 72 can be provided to transfer data between central datarepository 71 and one or more applications 73. Embodiments of theinvention can be implemented to provide the transfer in a manner that iscompliant with the security and privacy requirements of the HealthInsurance Portability and Accountability Act of 1996 (HIPAA).Additionally, embodiments can be implemented to allow secure sharing(including HIPAA-compliancy) of patient electronic health records (EHR)among doctors, hospitals and other healthcare workers and facilities.

Embodiments of the invention can be configured to allow a patient tovisit a healthcare facility and allow that healthcare facility toelectronically and securely access that patient's healthcare recordsfrom a remote location (or from local servers) for use in examining ortreating the patient. In some embodiments as more fully described below,patient health records can be flagged for delivery at a data repositoryand made available for transfer. A transfer utility can be configured toaccess the files, encrypt the data (original encryption, or second- orn^(th)-layer encryption) and transfer them to the physician or his/herpractice. A portal can be provided to receive the data from the transferutility and manage delivery to the designated physician/practice. Forexample, the portal can be configured to queue the items for delivery,add another layer of encryption, send the items to thepractice/physician, check for and store pending successful delivery. Thedata file or packet received from the repository can include routinginformation such as the data source (i.e., which repository sent thedata) and the destination (e.g., the physician or practice to which thefile or packet is to be sent).

The physician or his/her practice (or other healthcare worker orhealthcare facility) can include one or more client devices to receivethe files sent from the portal. The client devices (e.g., handheld,desktop or other computing device) can be configured to receive thedata, decrypt the data (each layer if multiple layers), perform anynecessary data conversion (e.g., from the data type used at the datarepository to a data type recognized by one or more applications used bythe physician or facility) and deliver the data to the appropriateapplication(s). The data received (or pulled) from the centralrepository can include patient information, billing information, EHRdata, etc. The client devices (e.g., applications running thereon) canuse this data to build a schedule (e.g., schedule of patient visits),link data to the schedule (e.g., link a patient's records, X-Rays, etc.to his/her corresponding schedule entry), update billing and paymentrecords and the like. The client devices (e.g., applications runningthereon) can allow the physician to enter information about the visit,can allow billing information to be updated, can allow inventoryinformation to be updated, and the like. Updated information can be sentback to the data repository either through the portal (e.g., in aprocess as described above) or otherwise.

FIG. 9 is a diagram illustrating an example block diagram for a datamanagement system and healthcare-practice management system inaccordance with one embodiment of the technology described herein.Referring now to FIG. 9 , the illustrated example data management systemincludes a clinic 81, a portal 82, and a client device 83. Although eachof these items is illustrated as a single entity, one or more of any ofthese items can be provided in a given application as may be desired.For example, there can be multiple client devices 83 interfacing througha portal to one or more central data repositories 81. In variousembodiments, and in the illustrated example, central data repository 81,portal 82, and client device 83 can be implemented to provide the samefeatures and functionality as described above with reference to FIGS.2-8 . Particularly, FIG. 9 provides one example implementation of thehealthcare management system in which clinic 81 includes a central datarepository 71, portal 82 includes a translator 72, and client device 83includes one or more applications 73. FIG. 9 and its accompanyingdescription provides more information on the data transfer and storageaspects of such a healthcare management system.

With continued reference to FIG. 9 , clinic 81 in this example includesa central data repository 71. In the illustrated example, central datarepository 71 includes data storage 84, transfer storage 85, and acommunications front end 87.

In the illustrated example, data storage 84 includes the storage ofvarious health or health-related, or patient-related, records such aspatient electronic healthcare records 88, patient management systemrecords 89, and patient billing system records 90. Each of these recordscan be stored in one or more data storage devices or facilities used byor having access to central data repository 71. For example, clinic 81can include one or more computerized systems to allow entry,maintenance, updating and storage of the records stored in thesedatabases. For example, a patient management system can be provided inthe clinic to manage information such as patient personal information(e.g. name, address, Social Security number, etc.), patient schedulinginformation (e.g. times and dates of previous and future appointments),patient-attending-physician information, and so on. Such a patientmanagement system stores its information in patient management systemrecords 89. As another example, a billing system can be provided tomanage a patient's billing information. The system can allow entry,tracking, maintenance and updating of patient billing information suchas, for example, patient insurance information, billing address, paymentinformation, payment history, Accounts Receivable, and the like. Such abilling system can be configured to store its information and billinginformation data store 90.

Temporary data storage 85 can also be provided to facilitate transfer ofinformation to client devices 83. The operation of temporary datastorage 85 in accordance with one or more embodiments is described infurther detail below with reference to FIG. 10 . Front end 87 can alsobe provided to provide a communications interface to other entities inthe system. For example, in the illustrated embodiment, front end 87provide signification interface to portal 82. Front end 87 can providetwo-way communications, including two-way communications to an interface91 at portal 82. In various embodiments, front end 87 can provide anynecessary format conversion as may be necessary or desired to allow aseamless transfer of information among the entities. Likewise, front end87 can also provide data encryption to add a measure of security to thedata transfer. Data can be encrypted according to various standards orother encryption techniques depending on the level of security requiredor desired. For example, in one embodiment, military grade encryption isprovided.

Portal 82 can be configured to provide temporary or long term datastorage for data being transferred among the various entities. Portal 82can also be configured to provide any additional encryption as may benecessary or desired to further secure information be transferred amongthe entities. Similarly, portal 82 can be configured to decrypt andre-encrypt information to provide compatibility of encryption standardsor encryption keys among entities which may otherwise be incompatible inthat regard. Portal 82 can also be configured to track the transmissionand receipt of information sent through it, by it, or to it, to confirmproper and complete receipt of information by itself or the intendedrecipient or recipients. In the illustrated example, portal 82 includesa translator 72. Translator 72 includes data storage 92, communicationsmanagement 93 and a communications interface 91. Storage 92 can beincluded to provide temporary or longer-term data storage for files,packets, records, or other information received by portal 82. Forexample, storage 92 can be configured to store data packets receivedfrom one entity and sent to another until such time as confirmation ofreceipt is received from the recipient. Interface 91 can be included toprovide a communications interface between portal 82 and the otherentities. For example, interface 91 can provide the physical layerfunctions for medications by portal 82. Additionally, interface 91 canbe configured to provide any encryption or decryption that may be used,format conversion, and other communications functions. Communicationsmanagement module 93 may be included to provide management and oversightof interface 91.

Is illustrated in FIG. 9 , a client device 83 is also provided. Inparticular, one or more client devices can be provided for use byphysicians or other healthcare practitioners or healthcare workers had amedical office or healthcare practice, or at another type of healthcarefacility. In the illustrated example, client device 83 includes one ormore applications 73. Applications 73 can include one or more healthcaremanagement applications 98 and an interface application 95. For example,the features and functionality described above with reference to thevarious embodiments can be implemented using one or more application 73on one or more client devices 83. Although one or more separatehealthcare management applications 98 and interface application 95 areshown, as would be appreciated by one of ordinary skill in the art afterreading this description, lease can be implemented as a singleconsolidated application 73.

Interface 95 can be included to provide interface functions to allowtransfer of data to and from the other entities in the system. Forexample, interface application 95 can be provided at to managecommunications between client device 83 and portal 82. Particularly, insome embodiments, interface application 95 can provide encryption,decryption, data translation or format conversion, data transfermanagement, and other functions useful in or desirable for the transferof information between client device 83 and the other entities.

Client device 83 can also include data storage 97 to store data,records, and other information used by application 73. Additionally,client device 83 may also include temporary data storage 85 that may beused by client device 83 and interface application 95 to facilitatereceipt and transfer of information between client device 83 and theother entities.

Also illustrated, is a user interface 96 they can be provided to allowapplications 73 to interface with users of the applications. Forexample, in one embodiment, (e.g., such as a handheld computing deviceembodiment) user interface 96 can be a touchscreen interface allowingthe display of information to the user as well as capturing inputprovided by the user. As will be apparent to one of ordinary skill inthe art after reading this description any of a number of differenttypes of user interfaces can be provided.

Although not specifically described above or illustrated in the drawing,the elements and modules described above with reference to FIG. 9 caninclude processing modules and other computing resources used toimplement the features and functionality described herein. For example,one of ordinary skill in the art after reading this description, willunderstand how one or more computing systems (e.g. enterprise computingsystems, desktop computing systems, workstations, computing modules suchas described below with reference to FIG. 11 , and other computingresources) can be used to perform features and functionality describedherein.

FIG. 10 is a block diagram illustrating an example process by whichhealthcare management information can be shared among various entities.This example is described in terms of the clinic 81 transferring recordsand information relating to one or more patients to a medical practicethat will be seeing those patients. As further illustration and for easeof discussion and understanding, this process is described in terms of aparticular example in which a medical practice is scheduled to see aplurality of patients on a given day and requests information andrecords for these patients from central repository. In this example, themedical office is an orthopedic medical practice, and clinic 81 is ahospital or other shared data management system maintaining patientrecords and information for a number of different patients who may beseen by different physicians, medical offices, or practices. It willbecome apparent to one of ordinary skill in the art how this process canbe applied to other practices, practice types and operational scenarios.

Referring now to FIG. 10 , at operation 424 clinic 81 pulls recordscorresponding to the patients that will be seen by the medical officefor a specified time period. For example, the system can be configuredto retrieve patient information for the medical office's daily patientschedule on a daily basis. Accordingly, in this example, the patientlisting for that day can be provided to clinic 81 by the medical officeso the clinic anyone knows which records to pull. As another example,scheduling information can be uploaded by the various medical offices orpractices to clinic 81 as the appointments are scheduled (or in batchesthereafter) and clinic 81 can be configured to store the scheduleinformation and retrieve the patient information for the scheduledappointments without the need for a separate schedule to be sent fromthe medical offices to the clinic 81. As a further example, the datamanagement system that clinic 81 can be configured to search thedatabase for a listing of patients have an appointment scheduled for aparticular medical office at a particular date. Clinic 81 can further beconfigured to retrieve patient records from the various data storagesystems 88, 89, 90 (and any others) for each of the patients with aschedule appointment. Clinic 81 then can be configured to make thisinformation available to front end 87 for communication to portal 82. Inthe example illustrated in FIG. 9 , central data repository 71 placesthis information into temporary data storage 85 (e.g. a logical orphysical data store such as a disk drive, folder or other storagespace), which can be accessed by front end 87. Central data repository71 can be further configured to include with these records informationregarding which medical office the record should be sent to.

At operation 425, front end 87 retrieves the information from temporarydata storage 85. In some embodiments, front end 87 can be configured tocheck data storage 85 periodically to determine whether there are anyrecords that are ready for transfer. In another embodiment, central datarepository 71 can be configured to alert front end 87 when records areplaced in temporary data storage 85 and ready for transfer. For example,a patient management system can be configured to run at central datarepository 71 to check patient schedules, pull patient files, anddeliver appropriate records to temporary data storage 85 (or otherwisemake them available for transfer to the medical office). In otherembodiments, records can be flagged for transfer and front end 87configured to periodically scan for flagged records. In someembodiments, flagging the records can include placing an instance of therecords in a designation location (e.g., data storage 85) when they areready for transfer. An instance of a record may be the original record,or it may be a copy.

At operation 430, front end 87 prepares and transfers the records toportal 82. In various embodiments, front end 87 can be configured toencrypt the records prior to transfer, perform any format conversionthat may be needed, penetrate the clinic firewall, and transfer therecords to portal 82.

At operation 433, portal 82 receives the records from central datarepository 71 via interface 91. Portal 82 stores the records using datastorage 92 and prepares the records for transfer to the medical office.In some embodiments, another layer of encryption can be added for datastorage 92. The records received by portal 82 can be stored in storage92 for a designated period of time. For example, in one embodiment, therecords are stored for 30 days, after which time they are deleted.Portal 82 (e.g., communication management 93) can be further configuredto determine the intended recipient (e.g. the designated medical office)of the records received. This information can be used by interface 91 totransfer the records to the appropriate medical office. In someembodiments, Portal 82 can be configured to receive, store and transfera plurality of records from a plurality of different sources to one ormore designated health care facilities. Portal 82 can, for example,provide virtual cloud storage and communications management to receiverecords from multiple sources, store the records, identify theappropriate recipients, group the records for transport and transportthe records to the intended recipient.

At operation 435, interface 91 transfers the records to the medicaloffice. Depending on its configuration, the medical office can beconfigured to receive the records at a front end system can furtherdistribute them to one or more client devices 83, or it can beconfigured to receive the records directly into one or more clientdevices 83. Interface 91 can be configured to add another layer ofencryption prior to sending the records to the medical office.Communication management 93 can oversee the communication process,manage the queuing of information, and check for an acknowledgment orconfirmation from the medical office that the information was correctlyreceived. If the knowledge meant does not come in an appropriate periodof time, or fan error message is received, communication management 93can cause the records to be retransmitted to the medical office. On theother hand, once confirmation is received that the records weresuccessfully transferred, the communication management module 93 candelete the records from storage 92. In some embodiments, portal 82 isimplemented as a cloud system and storage 92 as cloud storage.Accordingly, the one or more layers of encryption that can be applied tothe data may be desirable to protect the integrity of the records in thecloud. Various encryption standards can be used including, for example,128-bit military grade encryption to secure the data. In someembodiments, a cloud data service such as, for example, the CloudPrimeCloud Messaging product (available from CloudPrime at 300 Brannan St.,San Francisco CA, 94107) can be used to implement some or all of thefunctions of portal 82, front end 87, and interface 95.

At operation 438, the medical office receives the records. The medicaloffice decrypts the records and checks their integrity. As shown in theexample illustrated in FIG. 9 , this can be done by an interfaceapplication 95. Interface application 95 can be an interface applicationat a front-end system at the medical office, or it can be an interfaceapplication that is separate from or part of one or more applications 73running on a client device 83. Depending on the transfer process, and asindicated above, the records may be encrypted through one or more layersof encryption before they are received at the medical office.Accordingly, interface 95 can be configured to determine the levels andtypes of encryption applied decrypt information appropriately.Additionally, because the data types used by the various medical systemshad clinic 81 may be different from the datatype expected by clientdevice 83 (and indeed, different from system to system at clinic 81),interface 95 can further be configured to convert the datatype to thatexpected by client device 83, and more particularly to that expected bythe applications 73.

At operation 440, interface 95 makes the records available toapplications 73. Interface 95 can be configured to, for example, providerecords of different types to the appropriate corresponding healthcareapplications 98. In another embodiment, interface 95 can be configuredto make the records available, and the healthcare applications 98configured to retrieve records corresponding to their respectivefunctions. For example, patient data and scheduling records and patientbilling records can correspond to and be relevant to a treatingphysician's application, while billing records might correspond to abilling for Accounts Receivable application.

With the records available to the appropriate application orapplications 98, the records can be accessed by the healthcarepersonnel, used in the care and treatment of the patients, and updatedinformation can be entered into the applications 98 as appropriate.Completed or updated or annotated records, as well as new records can becreated and uploaded to central data repository 71 (e.g., through portal82) by the medical office. Accordingly, a temporary data storage folder87 can be provided in which this information can be stored for transferto the other entities by interface 95. Temporary data storage 87 canfunction in a manner similar to temporary data storage 85 at centraldata repository 71. That is, records can be stored in temporary datastorage 87 with recipient or other routing information, retrieved byinterface 95 and transferred.

As used herein, the term module might describe a given unit offunctionality that can be performed in accordance with one or moreembodiments of the technology disclosed herein. As used herein, a modulemight be implemented utilizing any form of hardware, software, or acombination thereof. For example, one or more processors, controllers,ASICs, PLAs, PALs, CPLDs, FPGAs, logical components, software routinesor other mechanisms might be implemented to make up a module. Inimplementation, the various modules described herein might beimplemented as discrete modules or the functions and features describedcan be shared in part or in total among one or more modules. In otherwords, as would be apparent to one of ordinary skill in the art afterreading this description, the various features and functionalitydescribed herein may be implemented in any given application and can beimplemented in one or more separate or shared modules in variouscombinations and permutations. Even though various features or elementsof functionality may be individually described or claimed as separatemodules, one of ordinary skill in the art will understand that thesefeatures and functionality can be shared among one or more commonsoftware and hardware elements, and such description shall not requireor imply that separate hardware or software components are used toimplement such features or functionality.

Where components or modules of the technology are implemented in wholeor in part using software, in one embodiment, these software elementscan be implemented to operate with a computing or processing modulecapable of carrying out the functionality described with respectthereto. One such example computing module is shown in FIG. 11 . Variousembodiments are described in terms of this example-computing module 500.After reading this description, it will become apparent to a personskilled in the relevant art how to implement the technology using othercomputing modules or architectures.

Referring now to FIG. 11 , computing module 500 may represent, forexample, computing or processing capabilities found within desktop,laptop and notebook computers; hand-held computing devices (PDA's, smartphones, cell phones, palmtops, etc.); mainframes, supercomputers,workstations or servers; or any other type of special-purpose orgeneral-purpose computing devices as may be desirable or appropriate fora given application or environment. Computing module 500 might alsorepresent computing capabilities embedded within or otherwise availableto a given device. For example, a computing module might be found inother electronic devices such as, for example, digital cameras,navigation systems, cellular telephones, portable computing devices,modems, routers, WAPs, terminals and other electronic devices that mightinclude some form of processing capability.

Computing module 500 might include, for example, one or more processors,controllers, control modules, or other processing devices, such as aprocessor 504. Processor 504 might be implemented using ageneral-purpose or special-purpose processing engine such as, forexample, a microprocessor, controller, or other control logic. In theillustrated example, processor 504 is connected to a bus 502, althoughany communication medium can be used to facilitate interaction withother components of computing module 500 or to communicate externally.

Computing module 500 might also include one or more memory modules,simply referred to herein as main memory 508. For example, preferablyrandom access memory (RAM) or other dynamic memory, might be used forstoring information and instructions to be executed by processor 504.Main memory 508 might also be used for storing temporary variables orother intermediate information during execution of instructions to beexecuted by processor 504. Computing module 500 might likewise include aread only memory (“ROM”) or other static storage device coupled to bus502 for storing static information and instructions for processor 504.

The computing module 500 might also include one or more various forms ofinformation storage mechanism 510, which might include, for example, amedia drive 512 and a storage unit interface 520. The media drive 512might include a drive or other mechanism to support fixed or removablestorage media 514. For example, a hard disk drive, a floppy disk drive,a magnetic tape drive, an optical disk drive, a CD or DVD drive (R orRW), or other removable or fixed media drive might be provided.Accordingly, storage media 514 might include, for example, a hard disk,a floppy disk, magnetic tape, cartridge, optical disk, a CD or DVD, orother fixed or removable medium that is read by, written to or accessedby media drive 512. As these examples illustrate, the storage media 514can include a computer usable storage medium having stored thereincomputer software or data.

In alternative embodiments, information storage mechanism 510 mightinclude other similar instrumentalities for allowing computer programsor other instructions or data to be loaded into computing module 500.Such instrumentalities might include, for example, a fixed or removablestorage unit 522 and an interface 520. Examples of such storage units522 and interfaces 520 can include a program cartridge and cartridgeinterface, a removable memory (for example, a flash memory or otherremovable memory module) and memory slot, a PCMCIA slot and card, andother fixed or removable storage units 522 and interfaces 520 that allowsoftware and data to be transferred from the storage unit 522 tocomputing module 500.

Computing module 500 might also include a communications interface 524.Communications interface 524 might be used to allow software and data tobe transferred between computing module 500 and external devices.Examples of communications interface 524 might include a modem orsoftmodem, a network interface (such as an Ethernet, network interfacecard, WiMedia, IEEE 802.XX or other interface), a communications port(such as for example, a USB port, IR port, RS232 port Bluetoothinterface, or other port), or other communications interface. Softwareand data transferred via communications interface 524 might typically becarried on signals, which can be electronic, electromagnetic (whichincludes optical) or other signals capable of being exchanged by a givencommunications interface 524. These signals might be provided tocommunications interface 524 via a channel 528. This channel 528 mightcarry signals and might be implemented using a wired or wirelesscommunication medium. Some examples of a channel might include a phoneline, a cellular link, an RF link, an optical link, a network interface,a local or wide area network, and other wired or wireless communicationschannels.

In this document, the terms “computer program medium and “computerusable medium” are used to generally refer to media such as, forexample, memory 508, storage unit 520, media 514, and channel 528. Theseand other various forms of computer program media or computer usablemedia may be involved in carrying one or more sequences of one or moreinstructions to a processing device for execution. Such instructionsembodied on the medium, are generally referred to as “computer programcode” or a “computer program product” (which may be grouped in the formof computer programs or other groupings). When executed, suchinstructions might enable the computing module 500 to perform featuresor functions of the disclosed technology as discussed herein.

While various embodiments of the disclosed technology have beendescribed above, it should be understood that they have been presentedby way of example only, and not of limitation. Likewise, the variousdiagrams may depict an example architectural or other configuration forthe disclosed technology, which is done to aid in understanding thefeatures and functionality that can be included in the disclosedtechnology. The disclosed technology is not restricted to theillustrated example architectures or configurations, but the desiredfeatures can be implemented using a variety of alternative architecturesand configurations. Indeed, it will be apparent to one of skill in theart how alternative functional, logical or physical partitioning andconfigurations can be implemented to implement the desired features ofthe technology disclosed herein. Also, a multitude of differentconstituent module names other than those depicted herein can be appliedto the various partitions. Additionally, with regard to flow diagrams,operational descriptions and method claims, the order in which the stepsare presented herein shall not mandate that various embodiments beimplemented to perform the recited functionality in the same orderunless the context dictates otherwise.

Although the disclosed technology is described above in terms of variousexemplary embodiments and implementations, it should be understood thatthe various features, aspects and functionality described in one or moreof the individual embodiments are not limited in their applicability tothe particular embodiment with which they are described, but instead canbe applied, alone or in various combinations, to one or more of theother embodiments of the disclosed technology, whether or not suchembodiments are described and whether or not such features are presentedas being a part of a described embodiment. Thus, the breadth and scopeof the technology disclosed herein should not be limited by any of theabove-described exemplary embodiments.

Terms and phrases used in this document, and variations thereof, unlessotherwise expressly stated, should be construed as open ended as opposedto limiting. As examples of the foregoing: the term “including” shouldbe read as meaning “including, without limitation” or the like; the term“example” is used to provide exemplary instances of the item indiscussion, not an exhaustive or limiting list thereof; the terms “a” or“an” should be read as meaning “at least one,” “one or more” or thelike; and adjectives such as “conventional,” “traditional,” “normal,”“standard,” “known” and terms of similar meaning should not be construedas limiting the item described to a given time period or to an itemavailable as of a given time, but instead should be read to encompassconventional, traditional, normal, or standard technologies that may beavailable or known now or at any time in the future. Likewise, wherethis document refers to technologies that would be apparent or known toone of ordinary skill in the art, such technologies encompass thoseapparent or known to the skilled artisan now or at any time in thefuture.

The presence of broadening words and phrases such as “one or more,” “atleast,” “but not limited to” or other like phrases in some instancesshall not be read to mean that the narrower case is intended or requiredin instances where such broadening phrases may be absent. The use of theterm “module” does not imply that the components or functionalitydescribed or claimed as part of the module are all configured in acommon package. Indeed, any or all of the various components of amodule, whether control logic or other components, can be combined in asingle package or separately maintained and can further be distributedin multiple groupings or packages or across multiple locations.

Additionally, the various embodiments set forth herein are described interms of exemplary block diagrams, flow charts and other illustrations.As will become apparent to one of ordinary skill in the art afterreading this document, the illustrated embodiments and their variousalternatives can be implemented without confinement to the illustratedexamples. For example, block diagrams and their accompanying descriptionshould not be construed as mandating a particular architecture orconfiguration.

The invention claimed is:
 1. A system to manage records and data in anorthopedic healthcare practice that is connected to a network, thesystem comprising: a nonvolatile data storage memory in which patientdata are stored; a server that is connected to the network and isprogrammed to receive over the network and store in the nonvolatile datastorage memory a set of individual patient data records of disparateform and format, wherein the set of individual patient data recordscomprises patient identification data for a plurality of patientsscheduled for appointments at the orthopedic healthcare practice in atime window and patients' health data, the server also programmed tostore inventory equipment records; a check-in client computing deviceconfigured to check-in patients for appointments, and having a displayscreen and having a network interface coupled to the network; whereinthe server is further programmed to access and retrieve from the datastorage memory patient data for the plurality of patients having anappointment during the time window, to translate the patient data to aform and format for an app running on the check-in client computingdevice, and communicating over the network the schedule of appointmentsin the time window to the check-in client computing device wherein theapp programs the check-in client computing device to receive theschedule of appointments and to control the display screen on which theschedule of appointments is displayed; wherein the app at the check-inclient computing device programs the check-in client computing device tocheck in a patient for an appointment at the orthopedic healthcarepractice at the check-in client computing device, comprising theprogrammed steps of: identifying the patient and confirming thepatient's name is on a list of patients having an appointment in thetime window; reviewing additional patient information as a gatekeepingfunction to determine if the patient has met certain requirements sothat a scheduled appointment can be approved, including at least one ofreviewing current insurance information for valid insurance of thepatient, verifying that co-payment has been made, verifying that a priortest on the patient has been completed, and verifying that a priorhealthcare practitioner examination of the patient has been completedbefore a scheduled test can be performed on the patient; and locking theappointment of a patient if review of the additional patient informationindicates that the patient has not met one of the requirements andtherefore the scheduled appointment is not approved and communicatingthe locked appointment to the server for storing in the data storagememory; a first hand-held computing device used by a first health carepractitioner (HCP) having a network interface coupled to the network;wherein the server is further programmed to translate the retrievedpatient data for the plurality of patients having an appointment duringthe time window to a form and format for use by an app in the firsthand-held computing device, to communicate the schedule of patientappointments to the app of the first hand-held computing device, theschedule showing the patient identifications for the plurality ofpatients scheduled and an appointment time corresponding to eachpatient, the displayed schedule including a listing of entries for asubset of the appointments scheduled at the orthopedic healthcarepractice in the time window; wherein the app running on the first HCPcomputing device further controls linking a schedule entry for a firstappointment of the schedule to at least part of a first health recordstored on the data storage memory that corresponds to a first patientassociated with the first appointment; wherein the app on the first HCPhand-held computing device receives a first user input from a healthcarepractitioner and selects the first patient or the first appointment thatis displayed on the schedule displayed on the first hand-held computingdevice for examination; wherein, in response to receiving the first userinput, the app at the first HCP hand-held computing device is programmedto display a link to at least part of the first health record if theappointment has been approved, or showing the appointment as lockeduntil approval of the appointment is granted; wherein the app of thefirst HCP hand-held computing device receives a second user input from ahealthcare practitioner as to examination of the selected patient, thesecond user input selecting the link to at least part of the firsthealth record; wherein, in response to receiving the second user input,the app of the first HCP hand-held computing device programs the firstHCP hand-held computing device to retrieve over the network from theserver and the data storage memory, via the network interface coupled tothe network and to store the examination of the selected patient in thedata storage memory; wherein the app of the first HCP hand-heldcomputing device receives a third user input from a healthcarepractitioner, the third user input including a prescription for anorthopedic brace for the first patient associated with the firstappointment; a second hand-held computing device used by a second healthcare practitioner (HCP) running an app wherein the app of the second HCPhand-held computing device includes a network interface coupled to thenetwork and the app transmitting to the server that the brace has beenobtained for the patient; wherein the app of the first HCP hand-heldcomputing device transmits to the app of the second HCP hand-heldcomputing device the orthopedic brace information with a key code toallow the second healthcare practitioner to access inventory storage toobtain the orthopedic brace for the patient; wherein the app of thesecond HCP hand-held computing device receives a fourth user inputindicating that the orthopedic brace has been fitted to the patient anddelivered to the patient; wherein the app of the second HCP hand-heldcomputing device transmits over the network to the server for storing inthe data storage memory the fitting information and the deliveryinformation of the orthopedic brace to the patient to update thepatient's health data in the data storage memory; and in the event thatthe brace did not fit the patient and has been returned to inventorystorage, the app of the second HCP hand-held computing devicecommunicates to the server to revise the inventory equipment records andthe patient health data to show that the brace has been returned;wherein the server is further programmed for accepting a fifth userinput at an app of the second HCP hand-held computing device from ahealthcare practitioner, the fifth user input entering treatmentinformation comprising information pertaining to an examination of thepatient associated with the first appointment and a patient diagnosis,for updating the patient's health data to reflect the treatmentinformation, and for storing, in the data storage memory, at least partof the updated first health record; wherein all apps of the HCPhand-held computing devices communicate in the same form and format ofdata for the communications recited herein and the server is programmedto communicate with all apps of the HCP hand-held computing devices inthat form and format of data and to translate all disparate data typesinto that form and format.
 2. The system to manage records and data ofclaim 1, wherein the individual patient data records further comprise atleast one of patient management system records and patient billingsystem records.
 3. The system to manage records and data of claim 1,wherein the individual patient data records further comprise datarelating to an outcome of prescribed follow-on care.
 4. The system tomanage records and data of claim 1, wherein the apps of the check-indevice and the first HCP hand-held computing device are furtherprogrammed to sort the schedule by at least one of attending physician,appointment time, and treatment room.
 5. The system to manage recordsand data of claim 1, wherein the app of the second HCP hand-heldcomputing device programs the second HCP hand-held computing device tocreate an order record, the order record comprising information aboutthe order for the orthopedic brace, and to communicate that order recordto the server for storage in the data storage memory.
 6. The system tomanage records and data of claim 1, wherein the server is furtherprogrammed for accepting from the app of the second HCP hand-heldcomputing device input confirming delivery of the orthopedic brace tothe patient associated with the first appointment and storing the inputin a patient file on the data storage memory.
 7. The system to managerecords and data of claim 1, wherein the server is further programmed toupdate the inventory records in the data storage memory to reflect thatthe orthopedic brace has been removed from inventory.
 8. The system tomanage records and data of claim 6, wherein the server has been furtherprogrammed to create a patient billing record to reflect that theorthopedic brace has been delivered to the patient associated with thefirst appointment.
 9. A system to manage records and data in anorthopedic healthcare practice that is connected to a network, thesystem comprising: a nonvolatile data storage memory in which patientdata are stored; a server that is connected to the network and isprogrammed to receive over the network and store in the nonvolatile datastorage memory a set of individual patient data records of disparateform and format, wherein the set of individual patient data recordscomprises patient identification data for a plurality of patientsscheduled for appointments at the orthopedic healthcare practice in atime window and patients' health data comprising at least a plurality ofa patient's condition, results of prior tests, prior diagnoses, x-rays,prior prescriptions, prescribed medications, and follow-up information,the server also programmed to store inventory equipment records; acheck-in client computing device configured to check-in patients forappointments, and having a display screen and having a network interfacecoupled to the network; wherein the server is further programmed toaccess and retrieve from the data storage memory patient data for theplurality of patients having an appointment during the time window, totranslate the patient data to a form and format for an app running onthe check-in client computing device, and communicating over the networkthe schedule of appointments in the time window to the check-in clientcomputing device wherein the app programs the check-in client computingdevice to receive the schedule of appointments and to control thedisplay screen on which the schedule of appointments is displayed;wherein the app at the check-in client computing device programs thecheck-in client computing device to check in a patient for anappointment at the orthopedic healthcare practice at the check-in clientcomputing device, comprising the programmed steps of: identifying thepatient and confirming the patient's name is on a list of patientshaving an appointment in the time window; reviewing additional patientinformation as a gatekeeping function to determine if the patient hasmet certain requirements so that a scheduled appointment can beapproved, including at least one of reviewing current insuranceinformation for valid insurance of the patient, verifying thatco-payment has been made, verifying that a prior test on the patient hasbeen completed, and verifying that a prior healthcare practitionerexamination of the patient has been completed before a scheduled testcan be performed on the patient; and locking the appointment of apatient if review of the additional patient information indicates thatthe patient has not met one of the requirements and therefore thescheduled appointment is not approved and communicating the lockedappointment to the server for storing in the data storage memory; afirst hand-held computing device used by a first health carepractitioner (HCP) having a network interface coupled to the network;wherein the server is further programmed to translate the retrievedpatient data for the plurality of patients having an appointment duringthe time window to a form and format for use by an app in the firsthand-held computing device, to communicate the schedule of patientappointments to the app of the first hand-held computing device, theschedule showing the patient identifications for the plurality ofpatients scheduled and an appointment time corresponding to eachpatient, the displayed schedule including a listing of entries for asubset of the appointments scheduled at the orthopedic healthcarepractice in the time window; wherein the app running on the first HCPcomputing device further controls linking a schedule entry for a firstappointment of the schedule to at least part of a first health recordstored on the data storage memory that corresponds to a first patientassociated with the first appointment; wherein the app on the first HCPhand-held computing device receives a first user input from a healthcarepractitioner and selects the first patient or the first appointment thatis displayed on the schedule displayed on the first hand-held computingdevice for examination; wherein, in response to receiving the first userinput, the app at the first HCP hand-held computing device is programmedto display a link to at least part of the first health record if theappointment has been approved, or showing the appointment as lockeduntil approval of the appointment is granted; wherein the app of thefirst HCP hand-held computing device receives a second user input from ahealthcare practitioner as to examination of the selected patient, thesecond user input selecting the link to at least part of the firsthealth record; wherein, in response to receiving the second user input,the app of the first HCP hand-held computing device programs the firstHCP hand-held computing device to retrieve over the network from theserver and the data storage memory, via the network interface coupled tothe network and to store the examination of the selected patient in thedata storage memory; wherein the app of the first HCP hand-heldcomputing device receives a third user input from a healthcarepractitioner, the third user input including a prescription for anorthopedic brace for the first patient associated with the firstappointment; a second hand-held computing device used by a second healthcare practitioner (HCP) running an app wherein the app of the second HCPhand-held computing device includes a network interface coupled to thenetwork and the app transmitting to the server that the brace has beenobtained for the patient; wherein the app of the first HCP hand-heldcomputing device transmits to the app of the second HCP hand-heldcomputing device the orthopedic brace information with a key code toallow the second healthcare practitioner to access inventory storage toobtain the orthopedic brace for the patient; wherein the app of thesecond HCP hand-held computing device receives a fourth user inputindicating that the orthopedic brace has been fitted to the patient anddelivered to the patient; wherein the app of the second HCP hand-heldcomputing device transmits over the network to the server for storing inthe data storage memory the fitting information and the deliveryinformation of the orthopedic brace to the patient to update thepatient's health data in the data storage memory; and in the event thatthe brace did not fit the patient and has been returned to inventorystorage, the app of the second HCP hand-held computing devicecommunicates to the server to revise the inventory equipment records andthe patient health data to show that the brace has been returned;wherein all apps of the HCP hand-held computing devices communicate inthe same form and format of data for the communications recited hereinand the server is programmed to communicate with all apps of the HCPhand-held computing devices in that form and format of data and totranslate all disparate data types into that form and format.
 10. Thesystem to manage records and data of claim 9, wherein the individualpatient data records further comprise at least one of patient managementsystem records and patient billing system records.
 11. The system tomanage records and data of claim 9, wherein the individual patient datarecords further comprise data relating to an outcome of prescribedfollow-on care.
 12. The system to manage records and data of claim 9,wherein the apps of the check-in device and the first HCP hand-heldcomputing device are further programmed to sort the schedule by at leastone of attending physician, appointment time, and treatment room. 13.The system to manage records and data of claim 9, wherein the app of thesecond HCP hand-held computing device programs the second HCP hand-heldcomputing device to create an order record, the order record comprisinginformation about the order for the orthopedic brace, and to communicatethat order record to the server for storage in the data storage memory.14. The system to manage records and data of claim 9, wherein the serveris further programmed for accepting from the app of the second HCPhand-held computing device input confirming delivery of the orthopedicbrace to the patient associated with the first appointment and storingthe input in a patient file on the data storage memory.
 15. The systemto manage records and data of claim 9, wherein the server is furtherprogrammed to update the inventory records in the data storage memory toreflect that the orthopedic brace has been removed from inventory. 16.The system to manage records and data of claim 14, wherein the serverhas been further programmed to create a patient billing record toreflect that the orthopedic brace has been delivered to the patientassociated with the first appointment.
 17. A system to manage recordsand data in an orthopedic healthcare practice that is connected to anetwork, the system comprising: a nonvolatile data storage memory inwhich patient data are stored; a server that is connected to the networkand is programmed to receive over the network and store in thenonvolatile data storage memory a set of individual patient data recordsof disparate form and format, wherein the set of individual patient datarecords comprises patient identification data for a plurality ofpatients scheduled for appointments at the orthopedic healthcarepractice in a time window and patients' health data, patients'management system records, patient billing system records, data relatingto an outcome of prescribed follow-on care, and at least a plurality ofa patient's condition, results of prior tests, prior diagnoses, x-rays,prior prescriptions, and prescribed medications, the server alsoprogrammed to store inventory equipment records; a check-in clientcomputing device configured to check-in patients for appointments, andhaving a display screen and having a network interface coupled to thenetwork; wherein the server is further programmed to access and retrievefrom the data storage memory patient data for the plurality of patientshaving an appointment during the time window, to translate the patientdata to a form and format for an app running on the check-in clientcomputing device, and communicating over the network the schedule ofappointments in the time window to the check-in client computing devicewherein the app programs the check-in client computing device to receivethe schedule of appointments and to control the display screen on whichthe schedule of appointments is displayed; wherein the app at thecheck-in client computing device programs the check-in client computingdevice to check in a patient for an appointment at the orthopedichealthcare practice at the check-in client computing device, comprisingthe programmed steps of: identifying the patient and confirming thepatient's name is on a list of patients having an appointment in thetime window; reviewing additional patient information as a gatekeepingfunction to determine if the patient has met certain requirements sothat a scheduled appointment can be approved, including at least one ofreviewing current insurance information for valid insurance of thepatient, verifying that co-payment has been made, verifying that a priortest on the patient has been completed, and verifying that a priorhealthcare practitioner examination of the patient has been completedbefore a scheduled test can be performed on the patient; and locking theappointment of a patient if review of the additional patient informationindicates that the patient has not met one of the requirements andtherefore the scheduled appointment is not approved and communicatingthe locked appointment to the server for storing in the data storagememory; a first hand-held computing device used by a first health carepractitioner (HCP) having a network interface coupled to the network;wherein the server is further programmed to translate the retrievedpatient data for the plurality of patients having an appointment duringthe time window to a form and format for use by an app in the firsthand-held computing device, to communicate the schedule of patientappointments to the app of the first hand-held computing device, theschedule showing the patient identifications for the plurality ofpatients scheduled and an appointment time corresponding to eachpatient, the displayed schedule including a listing of entries for asubset of the appointments scheduled at the orthopedic healthcarepractice in the time window; wherein the app running on the first HCPcomputing device further controls linking a schedule entry for a firstappointment of the schedule to at least part of a first health recordstored on the data storage memory that corresponds to a first patientassociated with the first appointment; wherein the app on the first HCPhand-held computing device receives a first user input from a healthcarepractitioner and selects the first patient or the first appointment thatis displayed on the schedule displayed on the first hand-held computingdevice for examination; wherein, in response to receiving the first userinput, the app at the first HCP hand-held computing device is programmedto display a link to at least part of the first health record if theappointment has been approved, or showing the appointment as lockeduntil approval of the appointment is granted; wherein the app of thefirst HCP hand-held computing device receives a second user input from ahealthcare practitioner as to examination of the selected patient, thesecond user input selecting the link to at least part of the firsthealth record; wherein, in response to receiving the second user input,the app of the first HCP hand-held computing device programs the firstHCP hand-held computing device to retrieve over the network from theserver and the data storage memory, via the network interface coupled tothe network and to store the examination of the selected patient in thedata storage memory; wherein the app of the first HCP hand-heldcomputing device receives a third user input from a healthcarepractitioner, the third user input including a prescription for anorthopedic brace for the first patient associated with the firstappointment; a second hand-held computing device used by a second healthcare practitioner (HCP) running an app wherein the app of the second HCPhand-held computing device includes a network interface coupled to thenetwork and the app transmitting to the server that the brace has beenobtained for the patient; wherein the app of the first HCP hand-heldcomputing device transmits to the app of the second HCP hand-heldcomputing device the orthopedic brace information with a key code toallow the second healthcare practitioner to access inventory storage toobtain the orthopedic brace for the patient; wherein the app of thesecond HCP hand-held computing device receives a fourth user inputindicating that the orthopedic brace has been fitted to the patient anddelivered to the patient; wherein the app of the second HCP hand-heldcomputing device transmits over the network to the server for storing inthe data storage memory the fitting information and the deliveryinformation of the orthopedic brace to the patient to update thepatient's health data in the data storage memory; and in the event thatthe brace did not fit the patient and has been returned to inventorystorage, the app of the second HCP hand-held computing devicecommunicates to the server to revise the inventory equipment records andthe patient health data to show that the brace has been returned;wherein the server is further programmed for accepting a fifth userinput at an app of the second HCP hand-held computing device from ahealthcare practitioner, the fifth user input entering treatmentinformation comprising information pertaining to an examination of thepatient associated with the first appointment and a patient diagnosis,for updating the patient's health data to reflect the treatmentinformation, and for storing, in the data storage memory, at least partof the updated first health record; wherein all apps of the HCPhand-held computing devices communicate in the same form and format ofdata for the communications recited herein and the server is programmedto communicate with all apps of the HCP hand-held computing devices inthat form and format of data and to translate all disparate data typesinto that form and format.
 18. The system to manage records and data ofclaim 17, wherein the apps of the check-in device and the first HCPhand-held computing device are further programmed to sort the scheduleby at least one of attending physician, appointment time, and treatmentroom.
 19. The system to manage records and data of claim 17, wherein theapp of the second HCP hand-held computing device programs the second HCPhand-held computing device to create an order record, the order recordcomprising information about the order for the orthopedic brace, and tocommunicate that order record to the server for storage in the datastorage memory.
 20. The system to manage records and data of claim 17,wherein the server is further programmed for accepting from the app ofthe second HCP hand-held computing device input confirming fittinginformation and the delivery information of the orthopedic brace to thepatient associated with the first appointment and storing theinformation in a patient file on the data storage memory.
 21. The systemto manage records and data of claim 17, wherein the server is furtherprogrammed to update the inventory records in the data storage memory toreflect that the orthopedic brace has been removed from inventory. 22.The system to manage records and data of claim 18, wherein the serverhas been further programmed to create a patient billing record toreflect that the orthopedic brace has been delivered to the patientassociated with the first appointment.